Which individual in the emergency department should be considered at highest risk for completing suicide?

A 38-year-old single, African American female church member with fibrocystic breast disease.

An adolescent Asian American girl with superior athletic and academic skills who has asthma.

A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate.

A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes.

Answer and Explanation

The Correct Answer is C

A. African American females, especially with strong religious affiliation and social ties, have a lower risk of suicide compared to other demographics.

B. Adolescents may have suicidal ideation under stress, but the protective factors (academic and athletic success, no indication of psychiatric illness) lower the risk.

C. Older white males are at the highest statistical risk for suicide, especially when compounded by chronic illness, terminal diagnosis, social isolation (single), and depression.

D. Despite chronic illness (type 2 diabetes), protective factors such as being married and having many grandchildren reduce suicide risk.

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Correct Answer is A

Explanation

A. Clozapine can cause agranulocytosis, a life-threatening drop in white blood cells, leaving the client highly vulnerable to infection. Flu-like symptoms (fever, sore throat, malaise) may be early warning signs and require immediate provider notification and WBC count monitoring.

B. Olanzapine commonly causes orthostatic hypotension. Dizziness when standing is expected early in treatment and can often be managed with slow position changes, not an emergency.

C. Thioridazine, like many antipsychotics, can cause sedation. Daytime drowsiness is a common side effect and not urgent.

D. Chlorpromazine may cause GI upset such as nausea and vomiting. While bothersome, it is not immediately life-threatening unless severe or persistent.

A. Justice B. Fidelity C. Beneficence D. Autonomy

Correct Answer is A

Explanation

A. Justice refers to fairness and equality in the distribution of care and resources. The nurse is concerned about whether patients exhibiting similar behaviors (self-mutilation) are being treated consistently and fairly, which directly relates to the principle of justice.

B. Fidelity involves keeping promises and commitments to patients, which is not the primary concern in this scenario.
C. Beneficence involves acting in the patient’s best interest to promote well-being. While relevant to care decisions, the main ethical issue here is fairness between patients.
D. Autonomy involves respecting a patient’s right to make their own decisions, which is not the central issue in comparing the care of two patients.

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Which individual in the emergency department should be considered at highest risk for completing suicide?

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